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CVNT2 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

what are the 6 basic classes of nutrients?

A 
protein
fat
carbohydrates 
minerals 
vitamins 
water
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2
Q

how much water should an animal have per day?

A

20-70 ml/kg/day

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3
Q

what is the normal urine output?

A

2ml/kg/hr

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4
Q

why are vitamins important?

A

for energy metabolism and biochemical reactions

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5
Q

which vitamins are water-soluble?

A

B and C

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6
Q

what are the fat-soluble vitamins?

A

A, D, E and K

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7
Q

what are the macrominerals?

A 
sodium
chloride
calcium 
phosphorous 
magnesium 
potassium 
sulphur
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8
Q

what are the most important microminerals?

A 
iron 
copper 
zinc 
manganese 
iodine 
selenium
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9
Q

why are cats obligate carnivores?

A

they cannot synthesise taurine within the body

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10
Q

what are the main functions of protein?

A

energy source

regulation of metabolism

cell and muscle fibre structure

tissue growth and repair

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11
Q

what are the essential amino acids?

A 
phenylalanine 
valine 
tryptophan 
threonine 
isoleucine 
methionine 
arginine 
leucine 
lysine 
taurine (cats only)
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12
Q

what can taurine deficiency in cats cause?

A

blindness, heart problems

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13
Q

what can excess dietary protein cause?

A

liver and kidney problems

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14
Q

what can protein deficiency cause?

A 
poor growth, muscle and weight loss 
dull hair/coat 
reduced immunity 
oedema (hypoalbuminaemia)
death
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15
Q

what are the functions of fats?

A

energy source

aid absorption of fat-soluble vitamins

enhance palatability

source of essential fatty acids

neural development

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16
Q

what can a deficiency in essential fatty acids cause?

A 
impaired reproduction 
impaired wound healing 
dry coat 
flaky skin 
eczema - hot spots
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17
Q

what are the 3 main groups of carbohydrates?

A

monosaccharides (glucose, fructose)
disaccharides (maltose, lactose, sucrose)
polysaccharides (starch, glycogen, fibre)

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18
Q

what is the function of carbohydrates?

A

energy - may be converted to fat

metabolic requirements for glucose

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19
Q

what is fibre made of?

A

indigestible polysaccharides - cellulose, lignin, pectin

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20
Q

what is the function of fibre?

A

adds bulk to the faeces

prevent constipation and diarrhoea

role in correction of obesity

role in regulating blood glucose levels in diabetes

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21
Q

what is the ideal body condition score for dogs?

A

4-5

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22
Q

what is the ideal body condition score for cats?

A

5

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23
Q

what is the basal energy requirement?

A

energy expended during sleep, 12-18hrs after feed, in a thermoneutral environment

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24
Q

what is the resting energy requirement?

A

BER plus energy expended for recovery from physical activity and feeding
Hospitalised patients

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25
Q

what is the maintenance energy requirement?

A

energy required by a moderately active animal

doesn’t include energy for growth, lactation or work

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26
Q

how do you calculate the RER for animals <2 or >45kg?

A

70 x (bw kg)^0.75

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27
Q

how do you calculate RER for animals 2kg-45kg?

A

30 x (bw kg) + 70

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28
Q

how is MER calculated?

A

RER x appropriate lifestage factor

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29
Q

what can cause obesity?

A

modern lifestyle
neutering
overfeeding
poor owner understanding

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30
Q

what are the possible consequences of obesity in dogs and cats?

A

hepatic lipidosis

joint disease

exercise intolerance

diabetes mellitus

cardiorespiratory disease

surgical implications

FLUTD

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31
Q

how do you calculate MER for an overweight animal?

A

based on ideal weight, not current weight

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32
Q

what is a realistic weight loss target?

A
  1. 8-1% for dogs

0. 5-1% for cats

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33
Q

what should obesity diets be?

A

nutritionally balanced

high protein

formulated for joint health

adequate levels of L-carnitine

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34
Q

what is L-carnitine?

A

non-essential amino acid

transports long-chain fatty acids into the mitochondria for use in beta-oxidation

(encourages use of fat as an energy source)

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35
Q

what is the function of L-carnitine in an obesity diet?

A

helps encourage use of fat for energy and reduce fat storage
reduces risk of hepatic lipidosis in cats

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36
Q

what should be considered in diets for GI disease?

A

highly digestible proteins and starch

MOS and FOS (prebiotics)

EPA/DHA (omega 3 EFAs)

psyllium

high fat vs. low fat

lypex supplement in patients with EPI/malabsorption syndromes

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37
Q

what is MOS and FOS?

A

mannan oligosaccharides from yeast cell walls

fructooligosaccharides from chicory/grains/barley/wheat

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38
Q

when might hypoallergenic diets be prescribed?

A

management of dogs with food allergy/hypersensitivity/intolerance
also useful for IBD and EPI

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39
Q

what are hydrolysed proteins?

A

proteins in food which have been broken down to the point where they no longer provoke an immune response

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40
Q

what components do hypoallergenic diets usually contain?

A

hydrolysed proteins/novel protein

skin barrier protection (B vitamins + amino acids + zinc + linoleic acid)

omega 3 fatty acids (EPA/DHA)

digestive security (beet pulp, FOS/MOS, zeolite)

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41
Q

what is the purpose of omega 3 fatty acids in hypoallergenic food?

A

help support skin and GI mucosal integrity

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42
Q

what is the purpose of zeolite in hypoallergenic food?

A

help support a healthy intestinal environment

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43
Q

what % of total energy should come from protein in convalescent diets?

A

30-50%

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44
Q

what forms do convalescent diets come in?

A

liquid, powdered and solid wet

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45
Q

why are critically ill patients at high risk of malnutrition?

A

catabolic depletion and rapid breakdown of energy and protein stores

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46
Q

how can you encourage a hospitalised patient to eat voluntarily?

A

calm environment

provide fresh food

warming the food - make sure it is palatable

make sure no physical barriers e.g. buster collars, saucers for cats

only try one food at a time

47
Q

when should an enteral feeding tube be considered?

A

when an animal cannot get adequate caloric intake through voluntary eating

48
Q

how can we alter food to help with dental health?

A 
provide dry food, large kibbles 
oral hygiene chews 
phosphate salts bind salivary calcium 
use of anti-gingipain IgY
addition of omega 3s and xylitol (not dogs?)
49
Q

how can we encourage patients to eat spontaneously?

A

try different textured and strong smelling foods, warmed foods

consider giving antiemetic medication/appetite stimulants/analgesia/pro-kinetics if required

TLC - grooming, cuddles, playing

offer food away from kennel

try their favourite treats

50
Q

what should we avoid doing when encouraging patients to eat spontaneously?

A

food buffets in kennels
introducing prescription diets (may create aversion)
don’t keep offering food if condition seems to be worsening - consider assisted feeding

51
Q

when is a feeding tube placed?

A

if a patient has been anorexic for 48 hours or more

if the vet anticipates the patient to be anorexic after a surgical procedure

if there is trauma to the mouth/head/neck

to administer oral rehydration or medication (maintaining normal ‘ins’ and ‘outs’)

52
Q

what types of feeding tube are there?

A

naso-oesophageal
oesophageal
percutaneous endoscopic gastrotomy (PEG) tube

53
Q

what equipment is required to place a naso-oesophageal tube?

A 
surgical stapler 
correct feeding and correct french gauge 
syringes (correct size for feeding tube) 
proxymetacaine (LA) 
sterile lubricant 
gloves 
sterile water 
tape
54
Q

briefly describe how to place a naso-oesophageal tube.

A
  1. measure correct size tube (tip of snout to 7th rib in cats/ 8th rib in dogs)
  2. apply proxymetacaine to one of the nares and around the nostrils
  3. apply sterile lubricant to end of tube and put patient in sitting position with control of the head
  4. direct tube in a medio-ventral-caudal direction - first part quickly, keep inserting until reach mark on tube
  5. check tube has negative pressure
  6. apply 10mls water for injection and monitor patient for respiratory distress
  7. apply tape to tube by the nares, staple/superglue in place to patients face (repeat again between eyes and between ears)
  8. place a buster collar
55
Q

how do you check placement of a N/O tube?

A

check for negative pressure using a syringe

administer 10mls of water and monitor for respiratory distress

56
Q

how do you administer a N/O tube feed?

A
  1. calculate required amount
  2. wear non-sterile gloves and draw up required amount into appropriate syringe
  3. pre-warm food within syringes in a warm water bath
  4. check for negative pressure
  5. administer 10mls water as pre-flush
  6. administer feed slowly over 10-15 mins, watch for signs of nausea/regurgitation (slow down/stop if seen)
  7. administer 10mls flush afterwards
57
Q

what are the nursing considerations for the N/O tube patient?

A

keep face and muzzle clean

tempt with food before every feed

take buster collar off for walks if putting it back on is well-tolerated

avoid food buffets in kennels

avoid offering prescription diets

58
Q

how long can a N/O tube be used for?

A

up to 7 days

59
Q

how do you remove a N/O tube?

A

remove by removing staples from patient or peeling away tape

using non-sterile gloves, pull gently out of the patients nose

60
Q

what are the contraindications for N/O tube placement?

A

patient who are comatose or have limited gag reflex/risk of aspiration

cat flu/congestion

rhinitis/epistaxis/head trauma

oesophageal disease

marked regurgitation

persistent vomiting

impaired gastric outflow

if nutritional support needed for >7 days

61
Q

what are the possible complications with N/O tube feeding?

A

patients removing their own tube

not getting negative pressure before a feed - tube displacement?

infection

reluctance to eat due to irritation from tube

aspiration

large dogs requiring very large feeds, small lumen

blockage

62
Q

what equipment is required for placing an oesophageal feeding tube?

A

feeding tube + correct french gauge

sterile and non-sterile gloves

curved artery forceps

surgical prep equipment (clippers/scrub/drape)

scalpel blade

bandage material

63
Q

how to you maintain an oesophageal feeding tube?

A

check stoma site 2x daily and assess for swelling/discharge/pain/redness

clean with 1:10 iodine

check for negative pressure and flush sterile water down the tube

redress

64
Q

what other nursing considerations should be given when nursing a patient with an oesophageal tube?

A

tempt with food before every feed

no neck collars/slip leads

administer medication through the tube to try and foster a positive relationship with food

avoid food buffets in kennels
avoid offering prescription diets

65
Q

how do you administer an oesophageal tube feed?

A

wear non-sterile gloves
pre-warm food syringes in warm water bath
check for negative pressure and administer 10ml flush
administer food slowly over 10-15 mins
flush again with 10ml and watch for signs of regurgitation/reflex/nausea
administer any medication
administer flush

66
Q

how long can an oesophageal tube be in place?

A

weeks to months

67
Q

how you you remove an oesophageal tube?

A

wear non-sterile gloves
cut suture holding the tube to the skin, gently pull away from patient
apply a primary dressing to cover the stoma site
can be managed by owner at home

68
Q

what are the contraindications for placing an oesophageal feeding tube?

A

persistent vomiting

reduced/impaired gastric outflow

comatose, recumbent or dysphoric patients - aspiration risk

oesophageal disease

69
Q

what are the possible complications of an oesophageal tube?

A

infection
loss of negative pressure - displacement
suture failure
blockage (rarer)

70
Q

what is a percutaneous endoscopic gastrotomy tube?

A

a tube which runs through the skin of the abdomen and the stomach wall and into the stomach cavity

71
Q

what equipment is required for placing a PEG tube?

A

correct size PEG tube kit (guide wire, needle/catheter, PEG tube)

endoscope
endoscope forceps

suture material

surgical prep equipment (scrub, drapes)

72
Q

how do you provide a feed through a peg tube?

A

wait 24 hours after placement
wear non-sterile gloves and pre-heat feed in a warm water bath

aspirate contents of stomach until you get negative pressure. measure volume and replace back through PEG tube

adjust feed as necessary and administer slowly over 20-25 mins

administer any medication
flush 10ml water through tube

73
Q

what are the nursing considerations for a PEG tube?

A

try to administer oral medications through PEG tube where possible

check stoma site twice daily as for O-tube care

stockinette instead of wrap dressing

tempt with food before every meal

74
Q

how long can a PEG tube be in place?

A

cannot remove for at least 7 days

can be in place for months

75
Q

how is a PEG tube removed?

A

can cut tube and will naturally pass through or firmly pull mushroom out of the stoma site?

76
Q

what are the advantages of a N/O tube?

A

no GA required
quick to place
easy removal, no healing required
well-tolerated

77
Q

what are the disadvantages of a N/O tube?

A

short term

risk of aspiration

irritating - can inhibit spontaneous eating

can block due to narrow lumen

feeds are time-consuming

78
Q

what are the advantages of an oesophageal tube?

A

can administer larger volumes more easily
can administer medications more easily
can be managed at home with owner

79
Q

what are the disadvantages of an oesophageal tube?

A

GA required

stoma site can become infected

can dislodge if patient vomits or regurgitates, aspiration risk

can get blocked

time-consuming feeds

80
Q

what are the advantages of a PEG tube?

A

large lumen to administer medication

can be in situ for months, managed by owner

81
Q

what are the disadvantages of a PEG tube?

A

GA required

has to be in situ for 7 days before removal - not good for short-term support

cannot use for first 24 hours

infection risk

82
Q

how much food can be given 24 hours after a PEG tube is placed?

A

1/3rd RER

83
Q

how much food can be given 48 hours after a PEG tube is placed?

A

2/3rd RER

84
Q

how much food can be given 72 hours after a PEG tube is placed?

A

all of RER

85
Q

what is the exocrine function of the pancreas?

A

synthesise and excrete digestive enzymes

86
Q

which dogs are pre-disposed to pancreatitis?

A

terriers, miniature poodles, miniature schnauzers

overweight dogs

87
Q

what is pancreatitis?

A

premature activation of digestive enzymes within the acinar cells resulting in pancreas autodigestion due to secretory block

88
Q

how does pancreatitis present?

A

vomiting
abdominal pain
anorexia
lethargy

89
Q

what can pancreatitis lead to?

A 
EPI 
chronic pancreatitis 
renal failure 
acute lung injury 
DIC
90
Q

what is the treatment for pancreatitis?

A

supportive - IVFT, antiemetics, analgesia, gastro-protectants
nutrition is key

91
Q

should pancreatitis patients be fasted?

A

no - no requirement to fast, causes increase in systemic inflammation

92
Q

what effect does early enteral nutrition have on pancreatitis? (first 48 hours of admission)

A

reduced bacterial translocation
reduced villus atrophy
reduced pancreatic inflammation

93
Q

what is important to remember when enteral feeding for pancreatitis?

A

avoid high fat diet due to concurrent hyperlipidaemia

prepyloric feeding well-tolerated in acute pancreatitis

lumen size may restrict diet choice

94
Q

which dietary components are important for normal skeletal development/maintenance?

A

calcium
phosphorous
vitamin D

95
Q

what is osteoarthritis?

A

progressive articular cartilage degradation

96
Q

what are 3 common orthopaedic conditions?

A

osteoarthritis
joint dysplasia
cranial cruciate ligament rupture/luxating patellae

97
Q

which dietary components are important in nutrition for arthritis?

A

weight management

omega 3 fatty acids (EPA/DHA - reduce inflammation)

glucosamine-chondroitin sulphate

98
Q

what is the function of glucosamine-chondroitin sulphate?

A

cartilage formation and repair
reduce inflammation
slow cartilage degeneration

99
Q

what are the dietary aims for treating diabetes?

A

achieving and maintaining normal serum glucose levels

decrease post-prandial glucose peaks

achieve normal metabolism of carbs/fats/proteins

normalise bodyweight

100
Q

what does DMB mean?

A

dry matter basis

101
Q

what % DMB should protein make up in a diabetes diet?

A

15-25% dogs

28-50% cats

102
Q

what % DMB should fat make up in a diabetes diet?

A

<20% DMB - high fat increases insulin resistance

103
Q

what % DMB should carbohydrate make up in a diabetes diet?

A

<30 DMB

104
Q

what other component is important in a diabetes diet?

A

insoluble carbohydrate (fibre) - important factor in DB management

105
Q

what dietary component is important to manage in hyperthyroidism?

A

iodine - dietary iodine required for production of thyroid hormone

106
Q

how can feline hyperthyroidism be treated/managed?

A

0.2ppm iodine DMB
e.g. Hills y/d
important that cat eats absolutely nothing else

107
Q

why should kidney function be monitored while treating hyperthyroidism?

A

can lower blood pressure = reduced perfusion to the kidneys

108
Q

which dietary alterations may help treat cardiac disease?

A

mild sodium restriction

sufficient taurine, L-carnitine, arginine, omega 3 fatty acids

109
Q

what is the importance of taurine in managing cardiac disease?

A

deficiency linked to DCM

especially relevant in cats

110
Q

what is the importance of L-carnitine in managing cardiac disease?

A

myocardial energy production

synthesised from lysine and methionine

111
Q

what is the importance of arginine in managing cardiac disease?

A

maintenance of normal vascular tone

112
Q

what is the importance of omega 3 fatty acids in managing cardiac disease?

A

reduces muscle loss

anti-arrhythmic effects

113
Q

how much L-carnitine should be included in the diet for cardiac disease?

A

50-100mg/kg PO q8h

CVNT2 (47 decks)

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